WILL TRAUMA GRIEF COUNSELING HELP?

By Janice Harris Lord, ACSW

Sudden death in the military isn't the same as an anticipated death. That's why "stages of grief" and books about grief following illnesses or advanced age seldom make sense after a traumatic death.

Those who don't know better may say, "Well, when he signed up for the military, everyone knew that this could happen." Yes, most families consider the risk, and, at the same time, pray and expect that their loved one will return home safely. Email, phone calls and other "real time" communications add to your assurance that your loved one, whether at training or in combat around the globe, is fine.

Military deaths come suddenly to those who are young and fit and serving their country - which makes their loss all the more difficult to comprehend because they are at the prime of their lives and ready to meet all the challenges that come their way. Military families sometimes think, because they are proud that their loved ones died while serving their country that they should not grieve - or at least not grieve deeply. That isn't so. It is not an "either/or" situation. You can be proud that your loved one served our country and, at the same time, deeply mourn all that you have lost.

Trauma death differs from other types of death in some critical ways and, not surprisingly, a survivor's reaction can differ too. Unlike most deaths from natural causes your loved one's death may have been:

someone's fault or even intentionally caused by someone else;

sudden and unexpected;

involved terrible harm to your loved one's precious body; and/or

happened very far away.

All of these factors can make grief work following a loved one's death more complicated.

It is not easy to decide if or when you need the help of a trauma grief counselor to help you with your grief. Most people find that counseling is helpful, even if they feel they could get along without it. Counseling certainly will not hurt you if your counselor has some understanding of trauma following the sudden, violent death of a loved one and is committed to treating survivors with dignity and compassion.

Trauma grief shares many symptoms with clinical depression:

Appetite changes

Sleep disturbances

Physical aches and pains

Decreased sexual desire

Loss of energy

Inability to concentrate

Need to withdraw

These trauma grief symptoms can be misdiagnosed if the counselor is not fully aware of what you have experienced. Some counselors are not aware that natural grieving often becomes clinical depression, particularly if the death is traumatic. Just as you take medicine to help you with the flu, high blood pressure, or diabetes, it is fine to take medicine to help soften trauma grief symptoms as well. Many of these symptoms can be significantly eased with small doses of antidepressants that can be prescribed by your primary care physician or a psychiatrist. The newer ones do not make you feel groggy or zombie-like. In fact, it may take several days or weeks before you feel their effect. Even then, you may not feel anything dramatic. You just realize that it is easier for you to sleep, to get up feeling refreshed, to get through your work day, and to enjoy some of the things you enjoyed before.

Other common reactions among trauma survivors include:

Unanticipated periods of crying (grief spasms);

Dreams and flashbacks;

Anger that is difficult to focus;

Difficulty deciding what to do with mementos, clothing and other possessions of the deceased;

Deep sadness, including irrational death wishes such as homicidal or suicidal fantasies; and/or

Fear and anxiety, particularly about getting out in the community alone.

No one knows for sure how long you should grieve, how many symptoms you should expect, or how intense a particular symptom will be for you. We do know that for most people, the grieving hurts and it lasts a long time.

On the other hand, it is crucial for you to realize that you will feel better over time. Time certainly does not "heal all wounds," but it does promote healing.

Anne Lamott says it well in her book, Traveling Mercies.

All those years I fell for the great palace lie that grief should be gotten over as quickly as possible and as privately. But, what I've discovered is that the lifelong fear of grief keeps us in a barren, isolated place, and that only grieving can heal grief. The passage of time will lessen the acuteness, but time alone, without the direct experience of grief, will not heal it.

Many survivors begin to rejuvenate on their own if they have family and friends who accept them, support them, and join them in their grieving. You will need to talk about the circumstances of the death and to share memories of your loved one over and over again. If your family or friends are unable or unwilling to be with you and hear you, you can find peer-based support from reading books of stories of other trauma grief survivors and by affiliating with organizations like TAPS, a group made up of those who understand because they, too, have lost a loved one. Many survivors find that support groups help them regain emotional health. If a group is not available, or you find that a group does not help, you may decide to seek professional help. Some choose professional help along with support groups.

Most people know when they need professional help. They know because their symptoms are severe or because they are not improving. Some know they need help because their emotional pain is too difficult to endure. They are exhausted, but can't sleep because of disturbing thoughts, memories, or nightmares. Sleep deprivation leads to irritability, anger outbursts, and depression. A professional trauma grief counselor can help you assess your thoughts, feelings, and symptoms to determine if they are appropriate to your loss and grief. It is paradoxical that sometimes when you are feeling unsure, you are actually progressing well through your grief. If you are better today than you were a week ago or a month ago, you are probably making reasonable progress. If you are the same or worse, you will probably benefit from help.

Finding a Good Trauma Grief Counselor

Not all counselors or psychotherapists are skilled at trauma grief therapy. Therefore, you may need to shop around for the right trauma grief counselor.

Word of mouth is the best referral source. Call the homicide or suicide support groups in your community and ask other survivors for the names of therapists they have found helpful. Many non profit counseling and support groups such as Compassionate Friends, Parents of Murdered Children, Mothers Against Drunk Driving (MADD) know counselors with expertise in trauma grief. Your local Mental Health Association should be able to refer you to an appropriate counselor.

After obtaining several counselor names, call several and ask some or all of the following questions:

Have you ever worked with clients whose loved one was killed? How many?

What kind of counseling do you do with people deeply in grief?

Under what circumstances do you arrange for prescription drugs?

About how many sessions do you have with a client who is having problems with grief?

What licenses or certifications do you have?

How much continuing education have you received during the last few years? Have you had any training in trauma grief therapy?

Do you provide individual counseling only or do you have support groups as well?

How much do you charge? Do you take insurance? Do you offer a sliding scale?

The most important rule in finding the right professional counselor is to trust your "gut" feelings. If, after two or three sessions, you do not feel supported, understood, and comfortable, you have the right to go elsewhere. You cannot get better in therapy unless you feel emotionally connected to the therapist in a way that makes you feel safe to share your thoughts and feelings honestly. Keep the following questions in mind throughout therapy:

Do I sense that my therapist is competent to work with victims who are mourning sudden violent death?

Do I feel that my therapist cares about me and recognizes my needs?

Do I feel that I am making reasonable progress?

Therapy can be painful. At the same time, you will find yourself looking forward to the sessions because you trust your counselor will treat you with dignity and compassion. If that does not happen, you may want to find another therapist.

All of those who have lost a loved one in the military have trauma grief counseling available to them through the Department of Veterans Affairs Readjustment Counseling Service's Vet Center Program. TAPS can help find the Vet Center nearest you and help set up an appointment.

This article first appeared in Volume 12 Issue 3 of TAPS Magazine. www.taps.org 800-859-TAPS. Reprinted with permission.